Frame of mind

One of the most important ways in which stories favor one perspective or another is in how they are framed. Which "side" of an issue does a story begin with? How is that side presented? After story selection itself (deciding which stories to report on and which to bypass), framing is one of the most important decisions journalists make. I thought of that when reading this highly informative piece in the Chicago Tribune:

If ever Carol Gaetjens becomes unconscious with no hope of awakening, even if she could live for years in that state, she says she wants her loved ones to discontinue all forms of artificial life support.

But now there's a catch for this churchgoing Catholic woman. U.S. bishops have decided that it is not permissible to remove a feeding tube from someone who is unconscious but not dying, except in a few circumstances.

People in a persistent vegetative state, the bishops say, must be given food and water indefinitely by natural or artificial means as long as they are otherwise healthy. The new directive, which is more definitive than previous church teachings, also appears to apply broadly to any patient with a chronic illness who has lost the ability to eat or drink, including victims of strokes and people with advanced dementia. ...

Gaetjens, 65, said she did not know of the bishops' position until recently and finds it difficult to accept.

"It seems very authoritarian," said the Evanston resident. "I believe people's autonomy to make decisions about their own health care should be respected."

The story goes on to explain this directive from the bishops and how it would affect Catholic hospitals.

But there was something rather significant that was missing from this story.

Just last week, the Los Angeles Times reported on a new study -- a study containing all kinds of religious ghosts -- that certainly should have been mentioned in this Chicago Tribune article:

In a study certain to rekindle debate over life-sustaining care for those with grievous brain injuries, researchers report that five patients thought to be in a persistent vegetative state showed brain activity indicating awareness, intent and, in at least one case, a wish to communicate.

Of 54 unresponsive patients whose brains were scanned at medical centers in England and Belgium, those five appeared able, when prompted by researchers, to imagine themselves playing tennis, and four of them demonstrated the ability to imagine themselves walking through the rooms of their homes.

One of those patients -- a 22-year-old man who had been unresponsive for five years after an automobile crash -- went on to respond to a series of simple questions with brain activity that clearly indicated yes or no answers, researchers said.

Last week, Reuters had another story about a 29-year-old man in a persistent vegetative state:

A man in a deeply unconscious state for five years has been able to communicate with doctors using just his thoughts in a study scientists say is a "game changer" for care of vegetative state patients.

Apparently researchers asked specific questions that would have objective answers (e.g. "Is your father's name Thomas?") and could tell whether the yes-answering portion of the brain lit up or the no-answering portion of the brain. Fascinating stuff.

Or do you remember this story from November?

A car crash victim has spoken of the horror he endured for 23 years after he was misdiagnosed as being in a coma when he was conscious the whole time.

Rom Houben, trapped in his paralysed body after a car crash, described his real-life nightmare as he screamed to doctors that he could hear them - but could make no sound.

'I screamed, but there was nothing to hear,' said Mr Houben, now 46, who doctors thought was in a persistent vegatative state.

Nowhere in the Tribune piece is the news from last week mentioned, much less any indication that people diagnosed as being in persistent vegetative states might be aware, intentional and desiring communication. That omission really hurts the article.

The bottom line: It's one thing to frame a piece to be favorable to those who oppose the Catholic Church's view that the severely disabled should not have nourishment withheld from them. But to not mention some of the recent breakthroughs the medical community has seen in communicating with the so-called vegetative does not serve readers well.

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